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What is Reflective Language?

Michael Hoffman, PhD

June 1, 2021

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What is reflective language?

Answer

Along the topic of listening, how do you show your patients that you are actually listening to them, and hearing what they're saying even if you are just dropping in for a quick check? The way that you can do that is through the purposeful use of reflective language.

Reflective language is telling a patient that you hear what they're saying, and then giving it back to them. These are all stems of a sentence that you can use when we are trying to practice reflective language:

  • "If I'm understanding you correctly..."
  • "It sounds like..."
  • "What I'm hearing is..." 
  • "I get the sense that..."
  • "It feels as though..." 

Examples may include: 

  • "If I'm understanding you correctly, you've been feeling extremely stressed recently because the doctors haven't been able to give you a clear sense of discharge."
  • "It sounds like you're really worried about moving forward with that procedure,"
  • "What I'm hearing is you're excited to go home"
  • "What I'm hearing is that you're super nervous about managing the trach before we get nursing assistants set up with you."

If you use reflective language with a patient, one of two things will happen. You are either going to accurately reflect what they say, in which they will be like, "Wow, he totally gets it - he was listening and understands what I said, and I like that guy." Or, you will learn that you are not entirely on point. That's okay too because these sentences are set up to give the patient the power to offer corrective feedback to you. When you start with "If I am understanding" or "It sounds like" or one of the other examples, it is clear that you are not being presumptive that you understand exactly what they mean.  Rather, you are indicating what you think you hear or understand and you are offering the chance for them to give feedback. It shows that you are open to hearing them. The patient might say, "Well, actually I meant more like this", and provide clarification. 

When we reflect back to someone, you want to use a downturn at the end of the sentence instead of an upturn. An upturn is what we naturally do when we ask a question. An upturn would be used with the question, "Do you want fries with that?", whereas a downturn would be used to reflect back: "I assume you want fries with that."  When we reflect back to someone, we're not using a targeted question; we're just making a statement, and we end it with a downturn.

Being a Person, Normalizing, and Reflective Language will immediately get you a lot of buy-in from families so that you will be able to offer support and advice.

This Ask the Expert is an edited excerpt from the course, Therapeutic Strategies for Counseling Complex Patients within a Pediatric Critical Care Settingpresented by Michael Hoffman, PhD.


michael hoffman

Michael Hoffman, PhD

Dr. Michael Hoffman is an Assistant Professor of Pediatrics at Thomas Jefferson University, Sidney Kimmel Medical College, and Pediatric Psychologist at Nemours/AI duPont Hospital for Children with a specialization in working with children with chronic medical conditions and their families. Dr. Hoffman completed his Ph.D. through the University of Miami Clinical Psychology program and his pediatric psychology residency and fellowship through Nemours/AI duPont Hospital for Children. His research and clinical work have centered on integrating psychological services into multidisciplinary clinics, including the cardiac intensive care unit, audiology, ENT, and cleft palate/craniofacial services, to improve quality of life in children and adolescents with medical complexity.  


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